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Introduction
On December 19, 2018, the Department of Health and Human Services (HHS) issued proposed regulations to rescind the requirement that employers and plan sponsors obtain and use a unique health plan identifier (HPID). Background The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required HHS to adopt a standard unique health plan identifier, to standardize the electronic transmission of certain health information. The goal of the requirement was to increase the efficiency and effectiveness of the healthcare system and to decrease the clerical burden on patients, providers, and health plans.  More and more employers are being overwhelmed by all of the compliance requirements associated with managing employee benefits.
The Guardian Life Insurance Company of America's "Benefits Balancing Act" study found that 60% of employers are feeling overwhelmed with the increased complexity of managing their benefits programs. One of the main reasons for the additional burden is the Affordable Care Act, with its myriad of compliance and reporting requirements. The large employer mandate and the documentation and new filing requirements with the IRS are high on the list of compliance issues, as are evolving Family Medical Leave Act (FMLA) and ERISA requirements. The IRS Office of Chief Counsel has issued a memorandum clarifying the tax treatment of certain types of fixed indemnity plans offered by employers. The memorandum states that the benefits provided by a fixed indemnity health plan must be treated as taxable income to an employee if the plan is employer-paid or if the employee can purchase the coverage on a pre-tax basis through a cafeteria plan.
The 21st Century Cures Act, passed and signed into law in December, includes a provision creating what is called a "Qualified Small Employer Health Reimbursement Arrangement" (QSEHRA). A QSEHRA allows small (non-ALE) employers who do not offer group health insurance to their employees to provide money to employees on a tax-free basis. The money can be used to pay for individual health policies and to reimburse employees for certain medical expenses.
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